Dynamics of sarcopenia after Roux-en-Y gastric bypass in patients with morbid obesity

Introduction. Roux-en-Y gastric bypass (RYGB) is one of the most popular bariatric procedures. However, the Impact of alimentary and biliopancreatic loops lengths on the results of Roux-En-Y Gastric Bypass with a maximum restrictive component remains insufficiently studied.Aim. To compare the long-term results of RYGB with a maximum restrictive component at different lengths of alimentary and biliopancreatic loops.Materials and methods. Our retrospective study included 170 patients: 98 (57.6%) in the group with long alimentary and biliopancreatic loops, 72 (42.4%) in the group with short loops. Follow-up examinations were carried out with a follow-up period of at least 24 months (median follow-up 38 months). In the first group, the lengths of the alimentary and biliopancreatic loops were 150 and 100 cm, in the second group – 100 and 60 cm respectively. In the preoperative period, all patients underwent a standard set of examinations with an obligatory determination of the skeletal muscle mass index using the bioelectrical impedance analysis. The size of the gastroenteroanastomosis was assessed 12 months after surgery using fibrogastroscopy.Results. Both groups showed good results in weight loss and control of associated diseases. The prevalence of moderate sarcopenia in the group of RYGB with long loops was 24.5% (19.4% in the preoperative period), severe sarcopenia was observed in 3% of the subjects (initially severe sarcopenia was not detected in any patient). In the group of RYGB with short loops, the incidence of sarcopenia increased from 13 to 16% (the difference is statistically insignificant). No pronounced sarcopenia was detected in this group after surgery.Conclusion. If patients have signs of moderate sarcopenia according to bioelectrical impedance analysis, type 2 diabetes mellitus, as well as in the elderly, it is advisable to perform RYGB with a minimal malabsorptive and maximum restrictive component.